How the insightful leadership of James English transformed a traditional dental school into a leading educational institution.

During the 1960s, the dental school at the University of Buffalo underwent a profound change, as a result of its merger with the State University of New York (SUNY), and, very importantly, because of the outstanding leadership provided by Dean James A. English. This article contrasts what the school was like in 1960 before Dean English's arrival, and what it had become in 1970 when his deanship ended.

Technological devices in the diagnosis of temporomandibular disorders.

Claims have been made that certain diagnostic devices should be routinely used to differentiate between jaw dysfunction and normal variation and between various pathologic conditions of the temporomandibular joint. The claims that jaw-tracking devices have diagnostic value for detecting TMD are not well supported by the scientific evidence. The clinical usefulness of electromyography devices is limited because of technical, methodologic, and data interpretation problems, as well as significant overlap between asymptomatic and symptomatic groups.

Care of patients with temporomandibular disorders: an educational challenge.

The ability to recognize, evaluate, and manage patients with temporomandibular disorders is an important component of general dental practice. Therefore, information about these disorders should be a basic part of the dental curriculum. Although most dental schools do include this subject in their educational programs, its teaching typically involves the presentation of didactic material in formal lectures or in seminars.

The Third Educational Conference to Develop the Curriculum in Temporomandibular Disorders and Orofacial Pain: introduction.

The principal aim of the Third Educational Conference to Develop the Curriculum in Temporomandibular Disorders and Orofacial Pain was to enhance the teaching of temporomandibular disorders (TMD) and orofacial pain to predoctoral dental students and to postdoctoral students in this field. Within this context, the conference sought to: (1) provide information regarding the current status of the predoctoral and postdoctoral teaching of TMD and orofacial pain, (2) present ways in which teaching of the basic sciences can be better integrated into the teaching of TMD and orofacial pain in the predoctoral and postdoctoral curriculum, (3) present ways in which the teaching of oral medicine can be better integrated into the teaching of TMD and orofacial pain in the predoctoral and postdoctoral curriculum, and (4) discuss how TMD and orofacial pain should be taught in a manner that is consistent with newly proposed accreditation standards. The papers addressing these specific aspects, as well as a summary paper on the conclusions from the conference, are presented in this issue of the journal.

Temporomandibular disorders and science: a response to the critics.

This article was prepared by the above authors and submitted to members of the TMD academic community for their endorsement. A total of 120 people signed an endorsement; their names are available on request.

Temporomandibular disorders and science: a response to the critics.

This article was prepared and submitted to members of the TMD academic community for their endorsement. A total of 120 people signed an endorsement; their names are available on request.

Current status of diagnostic procedures for temporomandibular disorders.

Temporomandibular disorders encompass a group of musculoskeletal conditions that involve the joints, the masticatory musculature, or both. In any given patient, there may be several overlapping TM disorders, an orofacial pain condition mimicking a TM disorder or a concomitant TMD and non-TM disorder. The differential diagnosis becomes extremely important.

Role of electronic devices in diagnosis of temporomandibular disorders.

The role of electronic devices in the diagnosis of TMD raises the critical question of whether the clinician can gain diagnostically relevant information from them. This is of serious concern in view of the sparse, unreplicated and invalidated scientific evidence linking the use of such devices to TMD diagnosis and subsequent therapy. Until such time as scientific studies, using blinded evaluations to compare TMD patients and controls, demonstrate acceptable levels of reliability, validity, sensitivity and specificity, as well as positive and negative predictive values, the use of such devices will continue to have questionable diagnostic validity and, therefore, will continue to be considered experimental.

Reliability and validity of diagnostic modalities for temporomandibular disorders.

Temporomandibular disorders (TMD) encompass a group of musculoskeletal conditions that involve the temporomandibular joint (TMJ) or joints, the masticatory musculature, or both. These conditions are typically characterized by pain in the pre-auricular area that is usually aggravated by chewing or other jaw function and is often accompanied, either singly or in combination, by limitation of jaw movement, joint sounds, palpable muscle tenderness, or joint soreness. As with most other musculoskeletal conditions, the diagnostic "gold standard" for TMD is based upon an evaluation of the patient's history and clinical examination, supplemented, when appropriate, by TM joint imaging.

Magnetic resonance imaging of the temporomandibular joint. Value of axial images.

The purpose of this study was to determine the value of axial images for diagnosis of disk displacement and osseous changes of the temporomandibular joint. Sagittal, coronal, and axial magnetic resonance images were obtained of 35 fresh temporomandibular joint autopsy specimens. The sagittal and coronal images were interpreted for position of the disk and osseous changes.

Clinical decision making for temporomandibular disorders.

Temporomandibular Disorders (TMD) encompass a number of clinical problems that involve the masticatory musculature, the temporomandibular joint (TMJ), or both. In any given patient, there exists the possibility of several overlapping TM disorders, an orofacial pain condition mimicking a TMD, or a concomitant TMD and non-TMD disorder. Since differential diagnosis involves the determination of which diseases or disorders a patient is suffering from by systematically contrasting the clinical characteristics, differentiation from among multiple possible conditions complicates the diagnostic process, which often must be approached with a certain degree of uncertainty.

Restoration of the vertical dimension of occlusion in the severely worn dentition.

The guidelines presented in this article for diagnosis and treatment of extreme tooth wear are not meant to be all inclusive. Every patient has unique treatment needs, and all of these needs may not be addressed specifically in this article. We believe, however, that careful adherence to the guidelines presented should facilitate a successful treatment of most if not all patients with moderate or severe tooth wear.

The dilemma of scientific knowledge versus clinical management of temporomandibular disorders.

The dilemma of scientific knowledge versus clinical management of TMD is discussed by focus on five questions; (1) What is scientific evidence and how is it transmitted? (2) What important evidence is lacking in the field of TMD? (3) What clinical concepts have been challenged by the scientific evidence? (4) Why is there adherence to concepts that appear to conflict with the evidence? (5) How does the clinician provide patient care in the face of uncertainty while retaining scientific integrity? It is concluded that no fundamental reason for a dilemma between scientific evidence and clinical practice need exist provided that (1) clinical investigators use appropriate research protocols and report results in refereed scientific journals and (2) dentists are familiar with the requirements of sound scientific evidence, interpret this evidence and its clinical implications, and apply it to the care of TMD patients.

Electronic technology for clinical prosthodontics.

A review of the literature on electrodiagnostic devices indicates that current studies have not substantiated claims regarding the utility of these devices in clinical dentistry. Research design problems, such as inadequate control subjects and use of inappropriate statistical tests, limit the conclusions that can be drawn from the results of these studies. Further research, including measurements of sensitivity and specificity, is needed in order to indicate the diagnostic utility of jaw tracking or electromyography in clinical dentistry.

Relationship of occlusal vertical dimension to the health of the masticatory system.

Changes in occlusal vertical dimension have been claimed to cause masticatory system disorders. Early articles on this subject were mainly limited to clinical case reports, and the more recent clinical studies have been flawed by the lack of control groups, blind evaluation, and by poor definition of criteria for evaluating the health of the masticatory system. Research with humans and animals has shown that if increases in occlusal vertical dimension are not extreme and the appliance used covers most of the dentition, there is a good possibility of adaptation.

Variability of closest speaking space compared with interocclusal distance in dentulous subjects.

Variability of closest speaking space was compared with that of interocclusal distance in 30 dentulous subjects to the nearest 0.1 mm on the screen of a mandibular kinesiograph. Postural rest position was elicited by the subjects saying /M/ and relaxing the jaw.

Evaluation of temporomandibular joint sounds. Diagnostic analysis and clinical implications.

This literature review and survey highlights the controversies surrounding the significance of joint sounds in general, the problems and pitfalls of joint sound analysis and interpretation, and the degree of importance given peripheral and temporomandibular joint sounds by physicians and dentists. The instrumentation and devices currently proposed for use in the detection and interpretation of joint sounds may not meet the standards of validity, reliability, sensitivity, and specificity, and as pointed out by one investigator, "The only objectivity currently associated with these instruments is their ability to record sounds of undetermined origin." In addition, no solid evidence is available that these particular sounds, when detected, are both repeatable over time and distinctly characteristic for particular disorders or significant pathologic changes.